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The dyspnoea-inactivity vicious circle in COPD: development and external validation of a conceptual model

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dc.contributor.author Ramon, Maria Antonia
dc.contributor.author Ter Riet, Gerben
dc.contributor.author Carsin, Anne-Elie
dc.contributor.author Gimeno Santos, Elena, 1980-
dc.contributor.author Agustí, Alvar
dc.contributor.author Antó i Boqué, Josep Maria
dc.contributor.author Donaire González, David
dc.contributor.author Ferrer, Jaume
dc.contributor.author Rodríguez, Esther
dc.contributor.author Rodríguez Roisin, Robert
dc.contributor.author Puhan, Milo A.
dc.contributor.author García Aymerich, Judith
dc.date.accessioned 2019-07-22T08:01:11Z
dc.date.issued 2018
dc.identifier.citation Ramon MA, Ter Riet G, Carsin AE, Gimeno-Santos E, Agustí A, Antó JM, Donaire-Gonzalez D, Ferrer J, Rodríguez E, Rodriguez-Roisin R, Puhan MA, Garcia-Aymerich J; PAC-COPD Study Group. The dyspnoea-inactivity vicious circle in COPD: development and external validation of a conceptual model. Eur Respir J. 2018; 52(3). pii: 1800079. DOI 10.1183/13993003.00079-2018
dc.identifier.issn 0903-1936
dc.identifier.uri http://hdl.handle.net/10230/42130
dc.description.abstract The vicious circle of dyspnoea-inactivity has been proposed, but never validated empirically, to explain the clinical course of chronic obstructive pulmonary disease (COPD). We aimed to develop and validate externally a comprehensive vicious circle model.We utilised two methods. 1) Identification and validation of all published vicious circle models by a systematic literature search and fitting structural equation models to longitudinal data from the Spanish PAC-COPD (Phenotype and Course of COPD) cohort (n=210, mean age 68 years, mean forced expiratory volume in 1 s (FEV1) 54% predicted), testing both the hypothesised relationships between variables in the model ("paths") and model fit. 2) Development of a new model and external validation using longitudinal data from the Swiss and Dutch ICE COLD ERIC (International Collaborative Effort on Chronic Obstructive Lung Disease: Exacerbation Risk Index Cohorts) cohort (n=226, mean age 66 years, mean FEV1 57% predicted).We identified nine vicious circle models for which structural equation models confirmed most hypothesised paths but showed inappropriate fit. In the new model, airflow limitation, hyperinflation, dyspnoea, physical activity, exercise capacity and COPD exacerbations remained related to other variables and model fit was appropriate. Fitting it to ICE COLD ERIC, all paths were replicated and model fit was appropriate.Previously published vicious circle models do not fully explain the vicious circle concept. We developed and externally validated a new comprehensive model that gives a more relevant role to exercise capacity and COPD exacerbations.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher European Respiratory Society
dc.relation.ispartof Eur Respir J. 2018; 52(3). pii: 1800079
dc.rights This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available at http://dx.doi.org/10.1183/13993003.00079-2018.
dc.title The dyspnoea-inactivity vicious circle in COPD: development and external validation of a conceptual model
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1183/13993003.00079-2018
dc.rights.accessRights info:eu-repo/semantics/embargoedAccess
dc.type.version info:eu-repo/semantics/acceptedVersion
dc.embargo.liftdate 2020-03-15
dc.date.embargoEnd info:eu-repo/date/embargoEnd/2020-03-15


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